Researchers in Holland have warned that the frozen face resulting from too much Botox could lead to depression.

Although it sounds sort of obvious - who wouldn't be depressed upon figuring out that she can no longer move her eyebrows? - lead researcher Dr Judith Grub believes that her study on Botox reveals a deeper link between freedom of facial motion and negative feelings. In the study, 30 people were shown a series of disturbing and gruesome images. Some of the participants were asked to keep a blank face while examining the photos, while others were allowed to express their natural reactions. Results showed that subjects who were unable to show their emotions perceived the world as a worse place, and held onto their negative feelings for longer. Grub said: "Suppressing negative emotions is something we do every day to be polite. However, my research shows that paralysing muscles that help you to express emotion leads to internalising these feelings."

Unsurprisingly, Botox doctors dispute Grub's findings. "Botox shouldn't paralyse the face and you should still be able to make facial expressions," said Dr. Patrick Bowler.

But maybe cosmetic treatment experts like Bowler should worry. Another kind of depression has lead to a significant decrease in the number of cosmetic procedures performed in 2008. The Times of London reports that the decline in procedures in the last few months of 2008 was so steep that it could force 15% of surgeons in Britain to close shop. Dr Hamish Laing explains: "There has been a significant drop across the country because cosmetic surgery is a lifestyle choice. When times are hard, people considering cosmetic surgery may decide to put it off." This fact, coupled with the rising cost of insurance premiums, has made it increasingly difficult for doctors to stay in business.

And it looks like the same thing is happening on this side of the pond. According to a report released by the American Society for Aesthetic Plastic Surgery, almost every procedure is down 10-12%, and total procedures are down 12.3%. Botox is still the most popular nonsurgical treatment for both men and women, but boob jobs have replaced liposuction as the most popular surgical procedure. The Aesthetic Society president, Alan Gold, attributs this change to "changes in fashion, i.e. décolletage baring styles." I'm not sure when décolletage baring tops were out of style with the boob job set, but this explanation makes just about as much sense as the recession justification.